Objective: To investigate the efficacy and complications of adenomammectomy with preservation of nipple and areolar sensation in treatment of gynecomastia. Methods: Fifty-eight patients with gynecomastia were randomly designated to observation group (28 cases) and control group (30 cases). Patients in observation group received liposuction and subtotal adenomammectomy with preservation of the superior lateral glandular flap, while those in control group underwent liposuction and adenomammectomy with only preservation of a small volume of glands behind the nipple-areola. All patients were followed up for 6 months after operation. The surgical efficacy and postoperative complications in the two groups of patients were observed and compared. Results: Operation was successfully completed in both groups of patients. The nipple-areola sensation and blood supply were significantly better in observation group than those in control group at 24 h after operation (χ2=9.946, P=0.007; χ2=4.913, P=0.026); the incidence of postoperative chest wall unevenness in observation group was significantly reduced compared with control group (χ2=4.392, P=0.036); no significant difference was found in incidence of either postoperative hematoma or seroma between the two groups (both P>0.05); the nipple-areola sensation was significantly better in observation group than that in control group at 6 months after operation (χ2=6.054, P=0.014). No recurrence was noted in either group during follow-up period. Conclusion: Compared with conventional liposuction and adenomammectomy, liposuction plus subtotal adenomammectomy with preservation of the superior lateral glandular flap offers advantage in postoperative appearance without increasing complications and especially, it can preserve the nipple-areola sensation and blood supply. So, it is recommended to be used in clinical practice.